Consumer behavioral segmentation – the next frontier in population health stratification

In my previous blogs I have outlined the need for providers to develop customer relationship management and patient relationship management capabilities but a fundamental requirement for success is the ability to segment the consumer and patient. Currently, providers are focused on segmenting patients based on their predictive clinical risk. The challenge to only leveraging predictive […]
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How engaged are your employees with their HSAs? Let’s find out.

Offering a qualifying high deductible health plan compatible with a health savings account (HSA) offers many benefits to your employees. But there’s a process to making the most of the health account. It starts with deciding to open an HSA and progresses with contributions and investing in mutual funds * for the long term. The […]
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Aligning network adequacy to meet greater expectations

With the passing of the Affordable Care Act (ACA) and the advent of the health insurance marketplace, network adequacy has come under greater scrutiny. Increased emphasis getting the right providers to consumers is leading health plans away from expansive networks to a narrow, more efficient network design that better serves member needs. Not lost in […]
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Population health stratification – thinking beyond the standard clinical risk segments

In my previous blogs I have outlined the need for providers to develop customer relationship management and patient relationship management capabilities which includes understanding the consumer’s perspective on health and the healthcare system. Currently providers are focused on understanding an individual’s clinical risk profile but it is important to integrate an individual’s attitude and activation […]
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Going global with your employee assistance and wellness programs? Make sure they are culturally relevant.

Over the next ten years, 75% of all United States-based companies will enter and compete in more countries1, yet 82% of these employers are seeking a single-source vendor solution for their employee assistance program (EAP) and wellness solution.1 If you’re considering an EAP and wellness program for international employees and expatriates, make sure you look […]
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NCQA member engagement standards change accreditation paradigm for Medicaid plans

ACA mandates that plans offering insurance products on health benefit exchanges (HBE) maintain full accreditation with standards boards like NCQA or URAC. Generally considered the gold standard for accreditation, state Medicaid programs are increasingly adding NCQA compliance to their contracts with Medicaid MCOs. Traditionally exempt from NCQA’s Member Connections standards (MEM), Medicaid MCOs must now […]
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Replacement costs: will knee and hip surgeries drive your medical costs?

Get ready for a big wave of orthopedic surgical costs. By 2020 employers may see the number of knee and hip replacements among their plan members double and spine operations increase by up to 80 percent.1, 2 Why? To start, our workforce is aging, with more employees age 55 or older3. Medical advances that reduce […]
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Integrated approach to customer relationship management and patient relationship management

As I have discussed in previous blogs, today’s health care trends challenge hospitals and physicians to think differently about how they engage the community and consumers. With new dynamics due to health care and market reforms and the retailization of health care, providers need to strategically and systematically think about how to engage the individual […]
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The first step on the journey to quality improvements: Analytic tools

Providers are increasingly turning to advanced analytical tools to efficiently gather clean and validated data, find patterns within that data and make more accurate predictions of population health needs. This data is helping them focus on the patients who have the most potential for clinical improvement—and cost savings. Dr. Carl Couch, president of Baylor, Scott […]
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Walk the walk: 3 tips for creating a culture of health

According to the Optum Wellness in the Workplace Study, 87% of employers report that health management solutions are an important component of their benefits mix. And over half of larger employers now offer health assessments, wellness coaching, fitness challenges and health and wellness websites.1 But how can employers engage employees and create a culture of […]
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